Months later, almost half of patients still haven’t fully recovered from Covid

A study of tens of thousands of people in Scotland indicated that 1 in 20 people who became ill with Covid-19 reported not having recovered, and another 4 in 10 patients had still not fully recovered from the infection many months later.

The authors of the study published last Wednesday (12) in the journal Nature Communications sought to identify the long-term risks of Covid, comparing the frequency of symptoms in people with and without a previous diagnosis of the disease.

People with previous symptomatic Covid infections reported certain persistent symptoms, such as shortness of breath, palpitations, and confusion or difficulty concentrating, three times more often than people who did not contract Covid, in surveys taken 6 to 18 months after infection. These patients were also at increased risk of more than 20 other symptoms linked to heart, respiratory health, muscle pain, mental health and the sensory system.

The finding reinforces scientists’ calls for broader options for long-term care for Covid patients in the United States and other countries. At the same time, it contains some good news.

The study did not identify greater risks of long-term problems for people who had asymptomatic Covid. And it found that, in a much smaller subset of participants who had taken at least one dose of the anti-covid vaccine before being infected, the vaccine appears to have helped to reduce or even eliminate the risk of some symptoms of long-term Covid.

According to the study, people who had severe early Covid are at greater risk of having long-term problems.

“The good thing about this study is that there is a control group and the scientists were able to isolate the portion of symptomatology attributable to Covid,” said Dr. Ziyad Al-Aly, director of research at the VA St. Louis Health Care System and clinical epidemiologist at Washington University in St. Louis, who was not involved in the study.

“It confirms the broader idea that long-term Covid is indeed a multi-system disorder,” said Al-Aly, who resides “not just in the brain, not just in the heart, but in all these areas.”

Jill Pell, a professor of public health at the University of Glasgow who led the research, said the findings reinforced the importance of patients with long-term Covid receiving support that is not limited to medical care but also involves needs related to work, education, low income and physical disability.

“The study showed us that Covid can present itself differently in different individuals and can have more than one impact on their lives,” Pell said. “Any approach to providing support needs to be personalized as well as holistic. The answer doesn’t just lie in the health sector.”

Long-term Covid involves a constellation of problems that can make life difficult for patients for months or even longer after infection. Over the past 12 months, researchers have paid more attention to the effort to understand the serious aftereffects, as the number of Covid cases has exploded and healthcare systems have learned to better deal with the early stages of infection.

US government estimates indicate that between 7.7 million and 23 million people in the country may have long-term Covid.

Globally, “the condition is devastating people’s lives and livelihoods,” World Health Organization Director-General Tedros Adhanom Ghebreyesus wrote in an article for the British newspaper The Guardian. He urged all countries to devote immediate and sustained attention equivalent to the scale of the problem.

The authors of the Scottish study followed 33,000 people who tested positive for the virus as of April 2020 and 63,000 people never diagnosed with Covid. At six-month intervals, these people were asked about any symptoms they had, including tiredness, muscle aches, chest pain and neurological problems, and what difficulties in everyday life.

By comparing the frequency of these problems with infected and uninfected people, the scientists tried to overcome a challenge faced by many other researchers who have studied long-term Covid: how to attribute less specific symptoms to Covid when these problems are also common in the general population and may be prevalent in the world. midst of a pandemic.

Several of the most common symptoms of long-term Covid identified in the study were also reported by a fifth to a third of participants who had never had Covid, the study found. But the symptoms were significantly more common in people who had had Covid: these participants tended to have 24 of the 26 symptoms identified by the study.

Among people who had previously had Covid, 6% said their most recent medical examination revealed they had not recovered, and 42% had only partially recovered.

Pell said he is still studying the long trajectory of Covid symptoms in the months and years that have passed since infection. But the new study opens a small window on that question. In a group of previously infected patients, 13% of people said their symptoms had improved over time, while 11% said they had deteriorated.

“Some of the symptoms resolve over time,” said Al-Aly, “but there are also a good number of people who remain symptomatic for a longer period, with different manifestations.”

Only a small proportion of study participants (4%) were vaccinated before contracting Covid, and many of them only with a single dose.

“Today we rely heavily on vaccination,” Pell said, “which does provide some protection, but not full protection.”

Women, the elderly and people living in poorer areas face more serious after-effects after a Covid infection. This is also true of people with preexisting health conditions, including respiratory illness and depression.

About 9 out of 10 study participants were white, making an effort to determine how and why long-term Covid risks differ across racial and ethnic groups.

Scientists say healthcare systems that are still struggling to recover from recent waves of Covid, while taking in many patients with flu and other respiratory illnesses, need considerably more resources to treat patients suffering the effects of a previous infection with the coronavirus.

“Our systems are not ready,” said Al-Aly.